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Obesity goes hand in hand with insulin resistance, which is a fundamental aspect of type 2 diabetes and is linked to hypertension, hyperlipidemia, atherosclerosis, polycystic ovarian disease, and metabolic syndrome. The human body maintains blood glucose within an extremely narrow range, utilizing the hormones insulin and glucagon, both of which are secreted by the pancreas. The production of these endocrine hormones ultimately determines if a person has disorders such as diabetes or hypoglycemia. Both hormones are secreted in response to blood glucose levels, but in opposing ways. Many mechanisms by which obesity causes systemic insulin resistance are still unknown. However, clinicians now understand the adipo-insulin axis that involves the adipocyte hormone called leptin. Its actions include the regulation of food intake and energy expenditure. Leptin also controls the insulin–glucose axis, peripheral glucose, and insulin responsiveness. This chapter focuses on the disorders of insulin regulation known as type 2 diabetes and metabolic syndrome.

The thyroid gland is the largest purely endocrine gland in the body. It is located in the anterior neck and has a butterfly-like shape. It curves across the anterior surface of the trachea and is slightly inferior to the larynx. This gland regulates basal body metabolism via the various hormones that it releases. The thyroid is also involved in gluconeogenesis, protein synthesis, glycogenolysis, lipogenesis, and thermogenesis. The parathyroid glands are embedded in the posterior surface of the lateral lobes of the thyroid gland and aid in calcium homeostasis.

Many factors have been implicated in the pathogenesis of migraine headache, including activation of the trigeminovascular system, dysfunction of: cerebral blood vessels, circulating vasoactive substances, mitochondrial energy metabolism, brain oxygenation and metabolism, platelet disorder, alterations in serotonin levels, low levels of brain tissue magnesium, altered transport of ions across the cell membrane, and inheritance and dysfunction of the brainstem periaqueductal gray matter. The headache phase of migraine is associated with cerebral vasodilation and inflammation, presumably mediated by the release of vasoactive substances and neuropeptides including CGRP (calcitonin gene-related peptide). Increased serum CGRP levels have been detected during migraine and cluster headache. One strategy to treat migraine is to inhibit the release of neuropeptides or to block their receptors. This article briefly reviews some experimental and clinical investigations focused on neuropeptide involvement in migraine. Drug Dev Res 68:294–314, 2007. © 2007 Wiley-Liss, Inc.